The effects of provider-prescribed obesogenic drugs on post-laparoscopic sleeve gastrectomy outcomes: a retrospective cohort study

Self Cite

Objective This study aimed to evaluate a possible association between the use of obesogenic medications and inadequate weight loss in a behavioral weight‐management program. Methods This is a case‐control, single‐center study of 666 adult patients within a Veterans Health Administration health system who participated in the MOVE! behavioral weight‐loss program. The cohort was divided into responders (n = 150), patients who achieved ≥ 5% total weight loss by the end of the MOVE! program, and nonresponders (n = 516), those who achieved < 5% total weight loss. We reviewed each patient’s medical records for exposure to obesogenic medication during the time of treatment. Results Approximately 62% (n = 411) of patients entering MOVE! had a prescription for obesogenic medications. Obesogenic medication use was associated with worse weight‐loss outcomes, and participants were 37% less likely to achieve a clinically meaningful (≥ 5% total weight loss) outcome at the end of the MOVE! program (odds ratio, 0.633; 95% CI: 0.427‐0.937; adjusted P = 0.022). Patients who received three or more medications (n = 72) had the greatest difficulty achieving 5% weight loss compared with the control group (odds ratio, 0.265; 95% CI: 0.108‐0.646; adjusted P = 0.003). Conclusions The use of provider‐prescribed obesogenic medications was associated with worse weight‐loss outcomes in a behavioral weight‐loss program. Closer scrutiny of patient medications is necessary to help improve outcomes of weight‐loss treatments.

Section: Discussionmentioning

confidence: 98%

Effect of Obesogenic Medications on Weight‐Loss Outcomes in a Behavioral Weight‐Management Program

Desalermos

Russell

Leggett

et al. 2019

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“…A similar effect of obesogenic medications was observed among patients undergoing a bariatric procedure (sleeve gastrectomy). Leggett et al (16) found that patients who were exposed to obesogenic medications had an 11.2% smaller mean percentage of excess weight loss after sleeve gastrectomy than those who were not. Their results showed that obesogenic medications interfere with weight loss significantly enough to modify the results of a behavioral intervention program as well as a bariatric procedure.…”

Section: Discussionmentioning

confidence: 99%

“…This could have resulted in underreporting of the obesogenic medication use and possible misclassification bias. Also, the list of obesogenic medications was not as comprehensive as other studies that focused on obesogenic medications (15,16). Second, the exact duration and dosage of medication use were not available.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous factors could influence the efficacy of a weight loss program. However, one study has suggested that obesogenic medications might have a role (14); in more recent studies, participants exposed to obesogenic medications have shown less weight loss after a behavioral weight loss program as well as after a bariatric procedure (15,16). We hypothesize that participants taking obesogenic medications were less responsive to a randomized clinical trial intervention as well.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Obesogenic Medication on Weight‐ and Fitness‐Change Outcomes: Evidence from the Look AHEAD Study

Moon

Almuwaqqat

2020

Objective This study evaluates whether obesogenic medications may decrease the effectiveness of lifestyle interventions. The authors of this study hypothesized that participants who took obesogenic medications would be less responsive to the intervention in the Look AHEAD trial. Methods In the trial, 5,145 participants with overweight or obesity, aged 45 to 76 years with type 2 diabetes, were randomly assigned to an intervention (vs. support and education). In this analysis, the association of exposure to obesogenic medications and successful weight loss (≥5% and ≥10% of total weight) and fitness gain (≥1 and ≥2 metabolic equivalents) was examined. For each outcome, multiple logistic regression models were fitted. Results Analytic sample sizes were 4,496 for weight‐change analyses and 4,051 for fitness‐change analyses. After adjusting for covariates, exposure to one or more obesogenic medications significantly decreased the odds of achieving ≥5% weight loss by 32% (odds ratio [OR] 0.68) and achieving ≥10% weight loss by 19% (OR 0.81). The association was dose‐dependent—participants using two or more medications were less likely to achieve weight loss than those using one medication. Obesogenic medication exposure was not associated with decreased odds of achieving fitness gain overall. Conclusions The results suggest that exposure to obesogenic medications could hinder successful weight loss in a lifestyle intervention for people with diabetes.

“…The high prevalence of obesity can be attributed to increased calorie intake and decreased energy expenditure, which are influenced by the availability of low-cost, energy-dense, highly palatable foods and an increasingly sedentary environment (3); however, other environmental factors such as medication use may also play a role. Many prescription medications have weight gain as an adverse and unintentional effect ("obesogenic" medications) (4,5), and the use of these medications has been recognized as a preventable cause of obesity (6). Although "obesogenic" as a term may be limited because weight gain does not always result in BMI ≥ 30 kg/m 2 , it is widely used to describe medication-induced weight gain.…”

Section: Introductionmentioning

confidence: 99%

Use of prescription medications associated with weight gain among US adults, 1999‐2018: A nationally representative survey

Hales

Ogden

et al. 2021

Objective: This study aimed to evaluate trends in the use of obesogenic medications among adults.Methods: Cross-sectional data on adults aged ≥20 years are from the 1999 to 2018 National Health and Nutrition Examination Survey (n = 52,340). Obesogenic medications were defined according to the 2015 Endocrine Society guidelines on the pharmacological management of obesity. Weight status was categorized according to BMI.Trends in prior 30-day use were evaluated. Results:In NHANES 2017-2018, 20.3% of US adults used an obesogenic medication.Beta-blockers (9.8%) and antidiabetics (5.7%) were the most common; antipsychotics (1.0%) were the least common. Most common indications were disorders of glucose metabolism, hypertension, neuralgia or neuritis, heart disease, and musculoskeletal pain and/or inflammation. From 1999 to 2018, the proportional use of obesogenic medications increased for anticonvulsants (34.4% to 55.0%) but decreased for antidepressants (32.1% to 18.8%), antidiabetics (82.9% to 52.5%), and beta-blockers (83.9% to 80.7%). The proportional use of obesogenic medications was not associated with weight status, except for antipsychotics.Conclusions: Use of obesogenic medications was common. Differences in the proportional use of obesogenic medication may reflect changing availability of obesogenic versus nonobesogenic medications over time. The decision to prescribe a nonobesogenic alternative, if one exists, is guided by weighing the risks and benefits of available treatments.